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<br />DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-020 <br />C.O. NO.: N/A <br />N.O.V. NO.: C-94-023 <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT OF <br />CIVII. PENALTY on the operator therein described by depositing a true copy thereof fast class, <br />postage prepaid in the United States mails at Denver, Colorado, addressed to the operator at the <br />address above, on October 13, 1994. <br />Certified Mail No. P 296 608 127 <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement conference as permitted by <br />C.R.S. 34-33-123(8). <br />Operator <br />By <br />(Signature) <br />Date <br />19 <br />M:\OSS\slw\9421 A <br />David A. Berry. Assessment Officer <br />Print Name and Title <br />